Varied presentation of mucormycotic skull base osteomyelitis: series of three cases

Acute invasive mucormycotic sinusitis causing skull base osteomyelitis (SBO) is very rare, occurs in immunocompromised patients and is usually fatal. Mucormycotic SBO in immunocompetent host is even rarer. They usually present late despite deep penetration of the disease into tissues of skull base and bone necrosis. We present here three cases of mucormycotic sinusitis with invasion of skull base in immunocompetent individuals. Computed tomography scan, biopsy and fungal smear was used in all three patients to differentiate it from osteonecrosis from malignancy. Prompt surgical debridement and prolonged antifungal therapy resulted in favourable outcome in all three patients. In this series we aim to review clinical features, management and prognosis. A high index of suspicion, diagnosis of atypical symptoms and prompt institution of combined therapy of surgical intervention, prolonged antifungal therapy are critical for favourable outcome.